Kidney Res Clin Pract.  2018 Dec;37(4):414-417. 10.23876/j.krcp.18.0048.

Disseminated adenovirus infection in a 10-year-old renal allograft recipient

Affiliations
  • 1Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
  • 2Department of Pediatrics, Hallym University Medical Center, Seoul, Korea.
  • 3Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.
  • 4Division of Nephrology, Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea. kanghg@snu.ac.kr

Abstract

Disseminated adenovirus infection can result in high mortality and morbidity in immunocompromised patients. Here, we report the case of a 10-year-old renal allograft recipient who presented with hematuria and dysuria. Adenovirus was isolated from his urine. His urinary symptoms decreased after intravenous hydration and reduction of immunosuppressants. However, 2 weeks later he presented with general weakness and laboratory tests indicated renal failure necessitating emergency hemodialysis. Adenovirus was detected in his sputum; therefore, intravenous ganciclovir and immunoglobulin therapy were initiated. Renal biopsy revealed diffuse necrotizing granulomatous tubulointerstitial nephritis compatible with renal involvement of the viral infection. Adenovirus was detected in his serum. Despite cidofovir administration for 2 weeks, adenovirus was also detected in the cerebrospinal fluid, resulting in generalized tonic-clonic seizure. The patient died 7 weeks after the onset of urinary symptoms. Adenovirus should be considered in screening tests for post-renal transplantation patients who present with hemorrhagic cystitis.

Keyword

Adenoviridae; Kidney transplantation; Opportunistic infections; Pediatrics

MeSH Terms

Adenoviridae Infections*
Adenoviridae*
Allografts*
Biopsy
Cerebrospinal Fluid
Child*
Cystitis
Dysuria
Emergencies
Ganciclovir
Hematuria
Humans
Immunization, Passive
Immunocompromised Host
Immunosuppressive Agents
Kidney Transplantation
Mass Screening
Mortality
Nephritis, Interstitial
Opportunistic Infections
Pediatrics
Renal Dialysis
Renal Insufficiency
Seizures
Sputum
Ganciclovir
Immunosuppressive Agents
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